Provider Demographics
NPI:1891388476
Name:TONGUE AND LIP-TIE CENTER OF NEW ENGLAND
Entity Type:Organization
Organization Name:TONGUE AND LIP-TIE CENTER OF NEW ENGLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVOIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-720-2121
Mailing Address - Street 1:2200 GAR HWY STE 3A
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-3935
Mailing Address - Country:US
Mailing Address - Phone:508-720-2121
Mailing Address - Fax:
Practice Address - Street 1:2200 GAR HWY STE 3A
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-3935
Practice Address - Country:US
Practice Address - Phone:508-720-2121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty